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Are face shields effective in preventing COVID-19 infections?

  • Key Finding: Direct evidence for face shields in minimizing COVID-19 infections among healthcare workers is already underway. Indirect evidence from a very low quality study show that suboptimal adherence in using face shields increases the risk of having influenza-like-illness among healthcare workers.


Are cloth masks effective in preventing COVID-19 infections?

  • Key Finding: There is no direct evidence on the effectiveness of cloth masks in preventing COVID-19 infections among healthcare workers or the general public. Indirect evidence suggest that although cloth masks may be as effective as medical masks in containing droplets, they have poor filtration efficiencies and are associated with higher risks for developing respiratory infections.


Should pooled sample testing using RT-PCR be used in screening patients suspected to have COVID-19?

  • Key Finding: Based on the current limited data, pooling of samples for the detection of SARS-CoV-2 using RT-PCR may warrant consideration especially among communities with low prevalence of COVID-19.


Which dialysis modality is most effective in treating acute kidney injury in COVID-19 patients? 

  • Key Finding: Very low-quality evidence from a single restrospective study suggests that continuous renal replacement therapy (CRRT) may reduce mortality among COVID-19 patients on invasive mechanical ventilation. Guidelines recommend CRRT for critically ill patients because it lessens contact with healthcare workers and reduces the risk of transmission.


Should negative pressure isolation rooms be used for COVID-19 patients? 

  • Key Finding: There is no direct evidence on the use of negative pressure isolation rooms (NPIRs) for COVID-19 patients in preventing nosocomial transmission to healthcare workers (HCWs) and other patients. Limited indirect evidence suggests that negative pressure isolation rooms may prevent nosocomial SARS among HCWs and other patients.


What dialysis method and practices would best reduce the risk of COVID transmission to healthcare workers performing dialysis on COVID patients? 

  • Key Finding: Guidelines recommend strict adherence to standard infection prevention and control measures within dialysis centers to minimize the risk of exposure of patients and HCWs to COVID-19. The ASN recommends the use of CRRT for critically-ill patients with COVID-19 to minimize the risk of possible transmission, if this option is available.


Is SARS-CoV-2 transmitted by asymptomatic and pre-symptomatic individuals? 

  • Key Finding: Asymptomatic and pre-symptomatic transmission of SARS-CoV-2 may occur based on low quality evidence.


What is the second sedative agent to add to dexmedtomidine for sedation of COVID-19 patients?

  • Key Finding: At present, there are no studies that evaluate the efficacy or safety of dexmedtomidine with another sedative agent among COVID-19 patients. Possible adverse events should be carefully considered in the choice of add-on sedative agent.


Should sanitation tents be used for prevention of COVID-19 transmission?

  • Key Finding: There is currently no evidence to support the use of sanitation tents in the prevention of COVID-19 transmission.


Should suspected or proven COVID-19 mothers continue to breastfeed their babies?

  • Key Finding: In limited studies, SARS-COV2 has not been detected in breast milk. However, there is not enough information to date on whether women who are sick with COVID-19 can pass the virus through breast milk.


Is SARS-CoV-2 transmitted by airborne route?

  • Key Finding: There is still limited evidence of SARS-CoV-2 airborne transmission.


Is there vertical transmission of SARS-CoV-2 in pregnancy?

  • Key Finding: There is limited evidence on the vertical transmission of SARS-CoV-2 in pregnancy.



Updated as of June 9, 2020


Through the volunteer work of more than 50 EBM practitioners, methodologists and students from the UP Institute of Clinical Epidemiology and Asia-Pacific Center for Evidence-Based HealthCare, the Philippine Society of Microbiological and Infectious Diseases (PSMID) had graciously agreed to host these rapid evidence reviews on COVID19. The aim is to retrieve, appraise, summarize and update the available evidence on COVID-related management, to assist the frontline health workers, local policymakers and government officials in their evidence-based critical decision-making.
The reviews should not replace individual clinical judgement and the sources cited should be checked. The views are not a substitute for professional medical advice. The views expressed represent the views of the authors and not necessarily those of their host institutions. This may change as new evidences emerges.
A discussion of the general methods used can be found here: Rapid Evidence Review General Methods.
For any questions or information, please email [email protected].